The influence of non-clinical eating-related psychopathology on the recognition of emotion from static faces and realistic social interactions

Emotion recognition deficits have consistently been reported in clinical and sub-clinical disordered eating. However, most studies have used static faces, despite the dynamic nature of everyday social interactions. The current aims were to confirm previous findings of emotion recognition deficits in non-clinical disordered eating and to determine if these deficits would be more evident in response to static as compared to dynamic emotional stimuli. We also aimed to establish if these emotion recognition deficits could be explained by comorbid psychopathology (depression, anxiety or alexithymia). Eighty-nine females were assigned to groups based on scores on the Eating Disorders Inventory (EDI); high (n = 45) and low (n = 44). Participants were presented with emotional faces and video clips portraying fear, anger, disgust, sadness, happiness, surprise and neutral affect. As predicted, the high EDI group correctly recognised fewer emotional displays than did the low EDI group. However, this deficit was not more evident for negative as opposed to positive emotions. Furthermore, the deficit was not larger for static stimuli in comparison to dynamic. Overall emotion recognition accuracy was negatively associated with Drive for Thinness, but not Bulimia or Body Dissatisfaction. Importantly, the emotion recognition deficits observed in the high EDI group and that were associated with eating disorder symptoms were independent of depression, anxiety and alexithymia. Findings confirm that even minor elevations in disordered eating are associated with poorer emotion recognition. This is important, as problems in recognition of the emotional displays of others are thought to be a risk factor for clinical eating disorders

Addressing Patients' Social Needs: An Emerging Business Case for Provider Investment

Despite growing evidence documenting the impact of social factors on health, providers have rarely addressed patients' social needs in clinical settings. But today, changes in the health care landscape are catapulting social determinants of health from an academic topic to an on-the-ground reality for providers, with public and private payers holding providers accountable for patients' health and health care costs and linking payments to outcomes. These new models are creating economic incentives for providers to incorporate social interventions into their approach to care. Investing in these interventions can enhance patient satisfaction and loyalty, as well as satisfaction and productivity among providers. A variety of tools for addressing patients' social needs are available to providers looking to leverage these opportunities. With the confluence of sound economics and good policy, investing in interventions that address patients' social as well as clinical needs is starting to make good business sense

Psychometric and Behavioral Measures of Central Auditory Function: The Relationship between Dichotic Listening and Digit Span Tasks

We hypothesized that the Digit Span (DS) subtest and component tasks (Wechsler, 1991) would show strong relationships with a dichotic listening test (Musiek, 1983). In two sets of archival clinical data (N = 74 and N = 51) we demonstrated that: (a) individuals with central auditory deficits had lower DS scores, F(1, 72) = 7.34, p = .008; η2 = .09; and (b) left-ear dichotic deficits impacted forward span, F(2, 48) = 8.45, p = .001. Right-ear dichotic listening performance also accounted for significant vari-ance in digit forward span (R2 = 0.17, p = .003). While limited in scope, the studies conclude that forward but not reverse span performance is strongly related to dichotic listening, and can serve as a marker for possible central auditory deficits

Psychometric and Behavioral Measures of Central Auditory Function: The Relationship between Dichotic Listening and Digit Span Tasks

We hypothesized that the Digit Span (DS) subtest and component tasks (Wechsler, 1991) would show strong relationships with a dichotic listening test (Musiek, 1983). In two sets of archival clinical data (N = 74 and N = 51) we demonstrated that: (a) individuals with central auditory deficits had lower DS scores, F(1, 72) = 7.34, p = .008; η2 = .09; and (b) left-ear dichotic deficits impacted forward span, F(2, 48) = 8.45, p = .001. Right-ear dichotic listening performance also accounted for significant vari-ance in digit forward span (R2 = 0.17, p = .003). While limited in scope, the studies conclude that forward but not reverse span performance is strongly related to dichotic listening, and can serve as a marker for possible central auditory deficits

“It's always on the safe list”: Investigating experiential accounts of picky eating adults

Previous research into severely restricted eating for reasons which are not cultural, medical, due to a lack of food or due to concerns about body image has focused predominantly on “picky/fussy eating” in children. Despite evidence that picky eating does continue into adulthood and recognition in the new diagnostic category Avoidant Restrictive Food Intake Disorder (ARFID) that problematically avoidant and restrictive patterns of eating affect people across the lifespan, relatively little is known about the challenges and consequences faced by older adolescents and adults. This research employs qualitative methods to explore the experience of living as an adult with picky eating behaviours. Semi-structured interviews were undertaken with thirteen adults who identify as picky eaters and eat a highly limited diet, as determined by a checklist food questionnaire. Data were analysed using interpretative phenomenological analysis (IPA). Two themes are presented in this paper: “Constructions of food” and “Motivators for and barriers to change”. These themes show the importance of how individuals perceive food, their diet and themselves, and implications for clinical practice and future research in light of these findings are considered

The influence of eating psychopathology on autobiographical memory specificity and social problem-solving

The primary aim was to examine to influence of subclinical disordered eating on autobiographical memory specificity (AMS) and social problem solving (SPS). A further aim was to establish if AMS mediated the relationship between eating psychopathology and SPS. A non-clinical sample of 52 females completed the autobiographical memory test (AMT), where they were asked to retrieve specific memories of events from their past in response to cue words, and the means-end problem-solving task (MEPS), where they were asked to generate means of solving a series of social problems. Participants also completed the Eating Disorders Inventory (EDI) and Hospital Anxiety and Depression Scale. After controlling for mood, high scores on the EDI subscales, particularly Drive-for-Thinness, were associated with the retrieval of fewer specific and a greater proportion of categorical memories on the AMT and with the generation of fewer and less effective means on the MEPS. Memory specificity fully mediated the relationship between eating psychopathology and SPS. These findings have implications for individuals exhibiting high levels of disordered eating, as poor AMS and SPS are likely to impact negatively on their psychological wellbeing and everyday social functioning and could represent a risk factor for the development of clinically significant eating disorders

The influence of emotional intensity on facial emotion recognition in disordered eating

Significant facial emotion recognition (FER) deficits have been observed in participants exhibiting high levels of eating psychopathology. The current study aimed to determine if the pattern of FER deficits is influenced by intensity of facial emotion and to establish if eating psychopathology is associated with a specific pattern of emotion recognition errors that is independent of other psychopathological or personality factors. Eighty females, 40 high and 40 low scorers on the Eating Disorders Inventory (EDI) were presented with a series of faces, each featuring one of five emotional expressions at one of four intensities, and were asked to identify the emotion portrayed. Results revealed that, in comparison to Low EDI scorers, high scorers correctly recognised significantly fewer expressions, particularly of fear and anger. There was also a trend for this deficit to be more evident for subtle displays of emotion (50% intensity). Deficits in anger recognition were related specifically to scores on the body dissatisfaction subscale of the EDI. Error analyses revealed that, in comparison to Low EDI scorers, high scorers made significantly more and fear-as-anger errors. Also, a tendency to label anger expressions as sadness was related to body dissatisfaction. Current findings confirm FER deficits in subclinical eating psychopathology and extend these findings to subtle expressions of emotion. Furthermore, this is the first study to establish that these deficits are related to a specific pattern of recognition errors. Impaired FER could disrupt normal social functioning and might represent a risk factor for the development of more severe psychopathology

Does walking protect against decline in cognitive functioning among breast cancer patients undergoing chemotherapy? Results from a small randomised controlled trial

Background Cancer related cognitive impairments have been subjectively reported and objectively detected in breast cancer patients treated with chemotherapy and are known to have a profound negative impact on productivity, psychosocial well-being and overall quality of life. Moderate levels of walking are known to be of benefit to the psychosocial well-being of those affected by breast cancer and for managing cognitive impairment in healthy adults, children, and the elderly. The purpose of this study is to investigate the effects of a home based, self-managed, moderate intensity walking intervention on subjective and objective cognitive functioning in breast cancer patients undergoing chemotherapy. Methods A home-based, self-managed intervention that consisted of moderate levels of walking was compared to usual care among breast cancer patients treated with chemotherapy in a randomised controlled trial. Outcome measures included changes in subjective (CFQ) and objectively detected cognitive functioning (Stroop, SART and two subscales from the WAISDigit Span and Block Design). Fifty participants were randomised to either the intervention group (n = 25), who completed 12 weeks of moderate intensity walking, or to the control group (n = 25) mid-way through chemotherapy. Results Compared with the control group, the self-managed walking intervention had positive effects on perceived cognitive function but not on sustained attention, executive function, memory or visual spatial skills when assessed objectively using neuropsychological measures. Conclusion This home-based, self-managed intervention is beneficial for protecting against perceived cognitive decline in breast cancer patients treated with chemotherapy. There is a need for further research to objectively assess cognitive decline within this population with larger sample sizes of patients. Trial registration Current Controlled Trials ISRCTN5070929

Direct and indirect effects of alexithymia on disordered eating in a non-clinical female sample: Determining the role of negative affect

Background: Alexithymia is an independent predictor of symptoms of eating disorders, but also influences disordered eating in clinical samples indirectly via negative affect (depression and anxiety). The aim of the current work was to establish if alexithymia predicts disordered eating in a non-clinical sample directly and indirectly (via negative affect). Methods: A sample of healthy females (n = 248) completed measures of depression, anxiety, alexithymia, and disordered eating (drive for thinness, bulimia, and body dissatisfaction). Bias-corrected bootstrapping was used to conduct parallel mediation analyses to determine if negative affect (depression and anxiety) mediated the influence of alexithymia on disordered eating. Results: The relationship between alexithymia (difficulty identifying feelings) and drive for thinness was mediated by depression but not anxiety. The link between difficulty identifying feelings and bulimia was mediated by anxiety but not depression. The correlation between alexithymia (difficulty describing feelings) and body dissatisfaction was mediated by both depression and anxiety. However, after controlling for negative affect, difficulty identifying feelings remained an independent predictor of drive for thinness, and difficulty describing feelings remained an independent predictor of body dissatisfaction. Conclusion: Facets of alexithymia (DIF and DDF) directly predict disordered eating in healthy participants as well as indirectly via depression and anxiety. These findings suggest that targeted interventions to improve the ability of individuals to identify and describe their feelings could be beneficial in reducing disordered eating, particularly in those “at risk” of developing eating disorders

Direct and indirect effects of alexithymia on eating disorder symptoms in a non-clinical female sample: determining the role of negative affect

Alexithymia, a multifaceted personality construct, characterised by difficulties identifying and describing one’s feelings, and by an externally focused cognitive style. Alexithymia is risk factor for negative affect and disordered eating. Previous work involving patients with anorexia nervosa revealed that high levels of alexithymia were directly linked to eating disorder symptoms and also indirectly linked via negative affect. Our aim was to establish if these findings generalised to subclinical disordered eating symptoms. A non-clinical sample of females (n=206) completed measures of depression, anxiety, alexithymia, and disordered eating. As expected, negative affect (combined depression and anxiety) mediated the effect of alexithymia (difficulty identifying feelings and difficulty describing feelings) on disordered eating symptoms (drive for thinness, bulimia, and body dissatisfaction). However, also as expected, direct effects of these alexithymia facets on disordered eating were still evident after controlling for negative mood. Our findings confirm that the relationships observed in patients with clinically diagnosed eating disorders are also evident in those with subclinical disordered eating. Targeted interventions to reduce deficits in recognising and describing one’s feelings could potentially ameliorate disordered eating in ‘at risk’ participants